michaelc
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Say No To T.D.S.
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Post by michaelc on Jan 5, 2019 16:44:04 GMT
Most people's use of the NHS is heavily skewed towards the end of life so a) be thankful you don't use it much and b) don't think you can get out of funding the NHS by paying extra for private insurance! Private insurance is only as cheap as it is because it doesn't cover the really expensive stuff when you really need it. And not only that, in my experience it often isn't as good. You typically get a small "hospital" for your procedure and if everything goes well then the experience is great - lovely new place and nice room like a posh hotel. If they go less well as they have happened to us, then you find out that once your surgeon has finished his operating list, he and the anesthetist bugger off leaving only a single junior doctor to look after the needs of the entire hospital. And if it goes even worse than that, (so I've read) they literally call 999 as they often don't have ambulance teams of their own 24/7. I've also read that they don't often have all kinds of things any major nhs operating theatre would have access to such as onsite blood and lots of other scary things. I don't particularly believe in private medicine but if you are going to have it, at least make sure that those like me who've paid for it a few times get as least as risk-free service as those who don't. I don't like the American system for it being very unfair on the poor but at least if you pay the dollars you get a fine service!
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cb25
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Post by cb25 on Jan 5, 2019 17:00:43 GMT
There aren't that many on £150K plus salaries, that's rare - basic NHS consultant salary only reaches £100K after 20 years as a consultant (and that's after 6 years medical school and at least 8 years speciality training, usually more). To get over £100K you need to do extra hours or get clinical excellence awards for doing extra duties above and beyond the normal. And it's the pensions distorted taxation that gives these 70% plus marginal rates (and sometimes over 100%) that mean it is not worth working extra and often is better to work less. Government knows but either doesn't care or has that little B word slightly more on its mind at the moment. Isn't part of the problem that we train too few doctors? Always seems like it. Interesting article here: "The number of medical school places will increase by 25% from 2018 under plans to make England "self-sufficient" in training doctors." www.bbc.co.uk/news/health-37546360
Amazes me that even with a Tory government (allegedly right of centre, despite much evidence in their policies), the state thinks it is correct to limit the labour force in an industry.
As to your point "I don't particularly believe in private medicine", what's the alternative - the state being the sole judge of what medical treatment it'll allow you to have. Completely outrageous idea imo.
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cb25
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Post by cb25 on Jan 5, 2019 17:40:55 GMT
Always seems like it. Interesting article here: "The number of medical school places will increase by 25% from 2018 under plans to make England "self-sufficient" in training doctors." www.bbc.co.uk/news/health-37546360
Amazes me that even with a Tory government (allegedly right of centre, despite much evidence in their policies), the state thinks it is correct to limit the labour force in an industry.
As to your point "I don't particularly believe in private medicine", what's the alternative - the state being the sole judge of what medical treatment it'll allow you to have. Completely outrageous idea imo.
Is it the state or the BMA, a closed shop Union in all but name? Dunno, though can see BMA might have an interest in keeping the number of doctors low and pay high, rather than numbers higher and pay decreasing
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IFISAcava
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Post by IFISAcava on Jan 5, 2019 18:20:09 GMT
Is it the state or the BMA, a closed shop Union in all but name? Dunno, though can see BMA might have an interest in keeping the number of doctors low and pay high, rather than numbers higher and pay decreasing
BMA didn't have much say in the matter, there was an independent pay review body to set fair pay. Then the government decided to ignore them and/or tell them not to bother because there was a pay freeze. Training more doctors is fine, and necessary, but remember it's expensive, and if you have unemployed doctors (or if they leave the NHS because you've squeezed pay and conditions too much) then you've wasted the money. Currently we import them from the EU, so didn't have to pay for their training, but we have abruptly stopped that now, the consequences of which we are about to see.
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IFISAcava
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Post by IFISAcava on Jan 5, 2019 18:28:27 GMT
Is it the state or the BMA, a closed shop Union in all but name? Dunno, though can see BMA might have an interest in keeping the number of doctors low and pay high, rather than numbers higher and pay decreasing
There's also this idea that medical students, and only medical students, have to pay back the cost of their training by working for a monopoly state employer for 4 years. Why don't law graduates, or accountants, etc etc have to work for the state to pay back the cost of their training too? It will be yet another reason why the brightest and best are no longer choosing medicine in the numbers they once did.
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ilmoro
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'Wondering which of the bu***rs to blame, and watching for pigs on the wing.' - Pink Floyd
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Post by ilmoro on Jan 5, 2019 18:39:26 GMT
Dunno, though can see BMA might have an interest in keeping the number of doctors low and pay high, rather than numbers higher and pay decreasing
There's also this idea that medical students, and only medical students, have to pay back the cost of their training by working for a monopoly state employer for 4 years. Why don't law graduates, or accountants, etc etc have to work for the state to pay back the cost of their training too? It will be yet another reason why the brightest and best are no longer choosing medicine in the numbers they once did. Where do accountants and lawyers do their training? Not in/with the monopoly state employer like doctors do. There is a cost above the fees to training doctors, doesnt seem unfair that NHS gets some benefit.
Are they? A quick google search brings up lots of articles about medical schools being massively oversubscribed.
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angrysaveruk
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Say No To T.D.S
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Post by angrysaveruk on Jan 5, 2019 20:19:30 GMT
There aren't that many on £150K plus salaries, that's rare - basic NHS consultant salary only reaches £100K after 20 years as a consultant (and that's after 6 years medical school and at least 8 years speciality training, usually more). To get over £100K you need to do extra hours or get clinical excellence awards for doing extra duties above and beyond the normal. And it's the pensions distorted taxation that gives these 70% plus marginal rates (and sometimes over 100%) that mean it is not worth working extra and often is better to work less. Government knows but either doesn't care or has that little B word slightly more on its mind at the moment. Isn't part of the problem that we train too few doctors? Not everyone is suited to being a doctor, you train the wrong person for the wrong vocation they wont last long. Vocational jobs like doctors/nurses, teachers, vampires (sorry I meant Lawyers) require a certain personality type. Ageing population means there will be an increased demand for medical professionals but the reality is you start training the wrong person for the wrong job they wont stick it out.
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Greenwood2
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Post by Greenwood2 on Jan 5, 2019 20:32:03 GMT
justme Do you have a solution? A lot of people say health services should be paid for by some form of insurance, but never go on to explain how the poor or unemployed would be treated when they couldn't afford the insurance. I think poor and unemployed should get the same - surely providing it for poor and unemployed only will be many times cheaper that to everybody and affordable as a result ? A small charge for not appearing for a booked appointment might concentrate minds, my GP has a monthly 'Did Not Attend' number on the reception desk which is ridiculously high, particularly when you find it very hard to get a quick appointment even for serious problems.
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angrysaveruk
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Post by angrysaveruk on Jan 5, 2019 20:33:21 GMT
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cb25
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Post by cb25 on Jan 5, 2019 22:45:21 GMT
I think poor and unemployed should get the same - surely providing it for poor and unemployed only will be many times cheaper that to everybody and affordable as a result ? A small charge for not appearing for a booked appointment might concentrate minds, my GP has a monthly 'Did Not Attend' number on the reception desk which is ridiculously high, particularly when you find it very hard to get a quick appointment even for serious problems. Bit of an odd idea imo, given we've paid for their labour regardless of whether/not we turn up (I always have). But, I'd agree if the NHS paid us every time they cancel an appointment or make us wait more than an hour.
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scc
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Post by scc on Jan 6, 2019 11:05:04 GMT
Isn't part of the problem that we train too few doctors? Not everyone is suited to being a doctor, you train the wrong person for the wrong vocation they wont last long. Vocational jobs like doctors/nurses, teachers, vampires (sorry I meant Lawyers) require a certain personality type. Ageing population means there will be an increased demand for medical professionals but the reality is you start training the wrong person for the wrong job they wont stick it out. I agree although there's more to the medical profession and routes in than doctors and traditional university pathways. For example, I'm impressed by the role that nurse practitioners are increasing playing in diagnosis and treatment of acute conditions (and presumably freeing up doctors). Equally, innovations like the virtual fracture clinic meant I was able to start rehabilitation ahead of a follow up appointment for a broken limb. The doctor I saw was impressed by the progress I'd made 5 weeks after the injury and it meant I was able to free up a physiotherapist because I didn't need an appointment with them.
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